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Biomedical subjects

M Baum

Publications and source records attributed to M Baum.

At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for breast cancer.

The standard adjuvant endocrine treatment for postmenopausal women with hormone-receptor-positive localised breast cancer is 5 years of tamoxifen, but recurrences and side-effects restrict its usefulness. The aromatase inhibitor anastrozole was compared with tamoxifen for 5 years in 9366 postmenopausal women with localised breast cancer. After a median follow-up of 68 months, anastrozole significantly prolonged disease-free survival (575 events with anastrozole vs 651 with tamoxifen, hazard ratio 0.87, 95% CI 0.78-0.97, p=0.01) and time-to-recurrence (402 vs 498, 0.79, 0.70-0.90, p=0.0005), and significantly reduced distant metastases (324 vs 375, 0.86, 0.74-0.99, p=0.04) and contralateral breast cancers (35 vs 59, 42% reduction, 12-62, p=0.01). Almost all patients have completed their scheduled treatment, and fewer withdrawals occurred with anastrozole than with tamoxifen. Anastrozole was also associated with fewer side-effects than tamoxifen, especially gynaecological problems and vascular events, but arthralgia and fractures were increased. Anastrozole should be the preferred initial treatment for postmenopausal women with localised hormone-receptor-positive breast cancer.

Anastrozole↗
PubMedDate not supplied

Plasma pyridoxine deficiency is related to increased psychological distress in recently bereaved homosexual men.

OBJECTIVE: Previous research has demonstrated that a theoretical model including measures of life stressors, social support, and coping style significantly predicts psychological distress. This study tested plasma pyridoxine (vitamin B6) deficiency status as a predictor of overall psychological distress and specific mood states in this model, controlling for HIV-1 serostatus. METHOD: Subjects included HIV-1+ (N = 76) and HIV-1- (N = 58) recently bereaved homosexual men. At baseline, subjects completed a battery of psychosocial questionnaires, together with a physical examination and venipuncture. The Profile of Mood States (POMS) provided measures of overall psychological distress as well as specific mood states. Pyridoxine deficiency status (a categorical measure of deficient vs. adequate status) was determined with a bioassay of erythrocyte aspartate aminotransferase activity. RESULTS: Pyridoxine deficiency was a significant predictor of increased overall psychological distress in this model, controlling for life stressors, social support, coping style, and HIV-1 serostatus. In post hoc analyses of specific mood state effects, pyridoxine deficiency status was significantly associated with increases in depressed, fatigued, and confused mood levels, but not with those of anxiety, anger, or vigor. DISCUSSION: These findings suggest that adequate pyridoxine status may be necessary to avert psychological distress in the setting of bereavement. Inasmuch as pyridoxine is a cofactor for 5-hydroxytryptophan decarboxylase--an enzyme in the biosynthesis pathway of serotonin--serotonin level in the brain is implicated as the mediating factor.

Adaptation, Psychological↗
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Mammography.

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Breast Neoplasms↗
PubMedDate not supplied

Quality of life during treatment for cancer.

Assessment of quality of life produces a hard outcome measure of treatment which allows us to tailor therapy to the patient's needs. This article look at ways in which quality of life can be measured and at its clinical importance in the treatment of cancer.

Humans↗
PubMedDate not supplied

Rotacor: a new rotary blood pump.

A new rotary blood pump was tested in calves for 6 hr. The pump consists of a rigid housing with a trochoidal internal surface, an inlet and outlet, and two lateral walls. A two-corner piston rotates on an eccentric shaft in a trochoidal path, thus creating a gap seal. The pump is driven by a water-cooled DC motor. For right ventricular assist, a cannula was inserted into the right ventricle through the right atrium, and into the left ventricle for left ventricular assist. From a total of 10 experiments, two left ventricular assists, two right ventricular assists, and three biventricular assists were evaluated. The pump produced a pulsatile flow of 3 L at 70 rpm. Energy requirements were 2.19 watts for left, 2.06 for right, and 7.26 for biventricular assists. Plasma hemoglobin remained as low as 10 mg/dl during monoventricular, and increased during biventricular assists to 20 mg/dl after 3 hr, when it started to chop again; after 6 hr it was 16 mg/dl. From these preliminary results it is concluded that this new type of blood pump may be suitable as a circulatory assist device.

Animals↗
PubMedDate not supplied

Functional heart replacement with the spindle pump: first results.

The spindle pump is a nonpulsatile blood pump with a double function, i.e., it works centrifugally and represses simultaneously. The first experiences with this type of pump used as a biventricular assist device in four short-term animal experiments (up to 13 hours) are described. It can be demonstrated that in cases of a normally beating heart, this BVAD decompresses both ventricles by 60-70%, while the aortic pressure is slightly increased; on the other hand, in case of ventricular fibrillation, the BVAD with two spindle pumps maintained the entire circulation, at an arterial pressure between 80 and 90 mmHg with a flow volume between 3.5 and 4 L/min.

Animals↗
PubMedDate not supplied

Testing "the soft option": trials of adjuvant endocrine therapy for the primary treatment of breast cancer.

Current concepts of the natural history of early breast cancer focus on a belief that for many women the tumor has disseminated prior to the time of diagnosis. For these women systemic treatment is essential to delay or prevent the return of the disease. Results of adjuvant chemotherapy trials indicate a benefit for premenopausal node-positive patients at the expense of toxicity. It is now being recognized that adjuvant endocrine therapy can obtain a similar advantage in a wider range of women with early breast cancer without the severity of side effects. This article seeks to review the role of adjuvant endocrine therapy: "the soft option."

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Clinical experience in the use of C. parvum in the treatment of locally advanced carcinoma of the breast.

Twenty-one patients with locally advanced breast cancer which had failed to respond to conventional therapy have been treated by infusion of C. parvum (strain CN 6134, Wellcome Research Laboratories) in 5% Dextrose. Thirteen patients had a single dose of 15 mg. C. parvum over 4 h and 8 patients received 5 daily infusions of 4 mg C. parvum over 1 h. In 3 patients there was some evidence of tumour regression. Pyrexia, often associated with rigors, headaches, vomiting and variations in blood pressure occurred in most patients receiving either schedule, although the severity of the side effects decreased daily in those receiving 5 treatments. One patient became comatose within 24 h of treatment and died two weeks later. Progressive swelling of the arm on the side of the tumour and inflammation of the primary lesion were prominent in those receiving 5 daily treatments. These results show that caution must be exercised in the clinical use of C. parvum and the search for an ideal schedule should continue.

Breast Neoplasms↗
PubMedDate not supplied

The effect of Corynebacterium parvum on the proliferation of monocyte precursors in the bone marrow of mice.

The anti-tumour activity of C. parvum is thought to be mediated via the monocyte/macrophage system (Scott, 1974). These cells originate from rapidly dividing precursors in the bone marrow and it might be at this level that C. parvum exerts its action. To test this hypothesis bone marrow T0 Swiss mice has been cultured according to the method of Bradley and Metcalf (1966), which gives an index of the number of proliferating macrophage precursor cells at the time of sacrifice. Experiments were set up at various times following a single i.p. injection of 700 microgram of an anti-tumour strain of C. parvum (CN 6134-Wellcome Research Laboratories). Controls received 700 microgram of either C. diphtheriae CN 2000 or C. parvum CN 5888, a strain with no anti-tumour activity. Macrophage colony counts in those mice receiving "active" C. parvum were significantly higher than those in controls at intervals from 2 h to 3 weeks post-treatment. This time course parallels certain immunological properties of C. parvum and suggests a possible mode of action.

Animals↗
PubMedDate not supplied

The effect of intravenous infusion of Corynebacterium parvum on an immune profile of women with breast cancer.

An immunological profile has been measured in 21 patients with advanced breast cancer who were treated with C. parvum (Wellcome strain CN6134). Thirteen patients received a single i.v. dose of 15 mg of C. parvum and 8 received 4 mg i.v. on 5 successive days. The "profile" was recorded before and 7-10 days after treatment and included measurement of total white count, absolute lymphocyte and monocyte counts, PHA response, B and T cell percentages. DNCB and Mantoux skin tests, immunoglobulin classes G, A, M and E and spleen size. Most patients showed a rise in white count, due largely to a polymorph leucocytosis, but there was no consistent change in any of the immunological variables recorded. IgG levels increased significantly following the single injection but not after the 5-day course; suggesting the possibility of acquired immunological tolerance. These results fail to demonstrate a consistent effect of C. parvum on either T-lymphocyte dependent function or on the spleen size, properties well documented in the experimental animal.

Breast Neoplasms↗
PubMedDate not supplied

Methotrexate therapy for complex graft rejection in pediatric heart transplant recipients. The Pediatric Heart Transplant Team--Loma Linda.

BACKGROUND: We retrospectively reviewed all pediatric heart transplant recipients at Loma Linda University Medical Center between January 1990 and September 1993 to evaluate the efficacy and safety of methotrexate when it is used for the treatment of graft rejection. METHODS: Twenty-eight of 156 patients (18%) received methotrexate therapy. The dose used for recurrent rejection was 10 mg/m2/week given every 12 hours for three doses. Rejection history, complete blood counts, liver function tests, and infectious complications were reviewed. RESULTS: Eighteen patients were treated for recurrent rejection. Methotrexate was begun at a median of 115 days (13 to 1093 days). Older patients were more likely to receive methotrexate (p < 0.01). Efficacy was assessed as rejection episodes (mean +/- standard deviation) occurring in the 2 months before methotrexate administration compared with the 2 months after methotrexate administration and fell from 2.0 +/- 0.2 to 0.6 +/- 0.2 episodes (p < 0.001). The rejection rate (rejections per patient-month) fell in treated patients to a rate similar to patients who did not receive methotrexate. Two patients (11%) died while receiving methotrexate. An additional nine patients were treated for acute rejection with hemodynamic compromise, and one was treated for graft-versus-host disease. The incidence of significant infections was 50% (but no deaths were due to infection) during methotrexate therapy in all patients treated (n = 28). The minimum white blood cell count in the first month of methotrexate therapy occurred at 2 weeks (median of 2700 to 3500 x 10(6) cells/L). Only one patient had elevated transaminase levels. CONCLUSION: Methotrexate is an effective and safe adjunct in the management of chronic pediatric cardiac graft rejection.

Adolescent↗